Download pdf - Titanium CAD Bridges with composite

Implant Direct

Titanium CAD/CAM bridgeswith composite

München, 25th of September 2010

Jan Willem Vaartjes, Amsterdam

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Full Arch bridges in your dental office

• Time consuming?

• Very expensive?

• A challenge?

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Implant Direct stands for:

• High Quality

• Cost Effective implant therapy

• All in One Packaging

• Innovations

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Implant Direct stands for:

Let me show you

How to use these principles to treat

your patients with an affordable and

also predictable solution

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Conventional full arch bridges

• Abutment level

• Casted (gold alloy) structure

• Fused porcelain

• Highly expensive

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• Abutment level

• Casted (gold alloy) structure

• Fused porcelain

• Highly expensive

Costs of materials €5000-€9000

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Titanium CAD CAM bridges

The smart alternative

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€2500-€3500

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• 1-piece, no welding needed, no weak points

• Very precise fit (CAM)

• No distortion and tension due to casting

• Computer Aided Design (CAD) possible

• Cost efficient

• Implant level possible, no abutments

€2500-€3500

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Mandibula vs Maxilla

4-5 implants

Anterior or ideally spread when possible

Esthetically, functional and phonetical predictable

6-8 implants

Stay out of the esthetic zone in resorbed ridges

Esthetically and phonetical challenging

Foramen Foramen

CuspidCuspid

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Access to oral hygiene!

Foramen Foramen

CuspidCuspid

Peri-implantitis in partially edentulous patients: association with inadequate plaque control

Clinical Oral Implants ResearchVolume 20, Issue 2, pages 169–174, February 2009

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Foramen Foramen

CuspidCuspid

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Foramen Foramen

CuspidCuspid

No saddles

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Foramen Foramen

CuspidCuspid

brush guidance

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The screw has to withstand the load

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Suitable type of implant connection

Better

Legacy Replant ScrewPlus & Swissplant

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• Internal bevel

• Flat connections

• External bevels

Better


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• Internal bevel


• External bevels

Better


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• Internal bevel


• External bevels

Better


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Zirconia vs Titanium in large bridgesCons:

Colour of the inner structure has minor aesthetic influence

No longterm studies for large Zirconia bridges

Titanium has a significant higher strength

Zirconia is brittle, (ageing process?)

Titanium is more price efficient

Comparable biocompatibility

Pro’s:

Porcelain can be fused or pressed more easily to Zirconia

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Composite for bridges

• Quick and efficient to apply

• Strong bond to titanium

• not abrasive for antagonising teeth

• Easy to repair intra-orally

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Case I: 5 ScrewPlus in the mandibula

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Cover screws with extenders

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Wound healing after 3 months

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Closed tray transfers

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Impregum impression

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Case I: 5 ScrewPlus in the mandibula

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Use the fixture mounts, they come for free!

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Fixed bite registration plate

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Wax setup

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Case I: Anterior Posterior Spread 1:2

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Case I: Milled titanium structure

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Case I: Milled titanium structure

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Case I: Sandblasting for retention

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Opaque

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Gradia GC composite, dentin layers

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GC Gradia composite, enamel layers

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Polishing

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End result

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Case I: Perfect fit

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Case II: Bredent technique

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Bredent veneers used for the setup

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Computer Aided Design

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Silicone key

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Smaller titanium structure

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Individual coloring

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Individual coloring

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Attaching veneers to Ti structure

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Individual grinding

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Finishing and completing

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Staining

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Thank you very much!